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Non-medical prescribing in nursing: the history and evolution of independent and supplementary prescribing

09 November 2023
Volume 32 · Issue 20


Non-medical prescribing has been shown to be beneficial to both service users and practitioners spanning all care sectors. Nurse prescribing has developed significantly in its short existence, and is set to continue to push the boundaries of practice as the role and education of nurses changes and adapts to current population healthcare needs. This article details the origins and evolution of non-medical prescribing, the variety of annotations found on the Nursing and Midwifery Council (NMC) register involved and how these affect nursing practice, as well as the expansion of roles. It also discusses supervision and assessment requirements in line with the NMC standards for prescribing programmes, and the Royal Pharmaceutical Society competence framework.

Non-medical prescribing is the term used for the prescribing activity by health professionals who are not doctors or dentists (Cope et al, 2016). This is only permitted following the successful completion of an approved prescribing qualification at a higher education institution, and subsequent attainment of annotation on the associated professional register, and employment permissions. Non-medical prescribing has developed significantly, with many health professionals having access to additional education that leads to the legal right to prescribe. Currently, nurses represent the largest proportion of non-medical prescribers in the UK (Armstrong et al, 2021). This article focuses on the evolution of non-medical prescribing relating to independent and supplementary prescribing (V300 annotation on the Nursing and Midwifery Council (NMC) register) within the nursing profession.

Non-medical prescribing was introduced originally to reduce doctors' workloads and to improve patient care (Paterson et al, 2016). This delegates responsibility for full episodes of care to skilled nurses, including patient assessment and diagnosis, leading to treatment of the condition, the organisation of further investigations when appropriate, and making referrals to specialists within the multidisciplinary team (Casey et al, 2020).

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